Miloradović Zoran, Jerkić Mirjana, Jovović Durdica, Mihailović-Stanojević Nevena, Milanović Jelica Grujić, Stosić Gordana, Marković-Lipkovski Jasmina
Institute for Medical Research, Dr Subotića 4, 11129 Belgrade, PO Box 102, Serbia.
Nephrol Dial Transplant. 2007 Sep;22(9):2476-84. doi: 10.1093/ndt/gfm213. Epub 2007 Jun 2.
Acute renal failure (ARF) is a devastating illness, especially when it occurs in various conditions with impaired nitric oxide (NO) synthesis, such as arterial hypertension, heart failure and some renal diseases. We have directed our investigations to effects of both angiotensin II (AII) and endothelin (ET) receptor blockade associated with mild or strong NO deficiency on haemodynamic, biochemical and morphological parameters in experimental post-ischaemic ARF.
In this study, we used bosentan (dual, ETA/ETB-receptor antagonist), losartan (non-peptide, competitive antagonist of type I AII receptor), and NG-nitro-L-arginine methyl ester (L-NAME), inhibitor of NO synthesis. Experiments were performed in anaesthetized, adult male Wistar rats. The right kidney was removed and the renal ischaemia was performed by clamping the left renal artery for 45 min. Experimental groups received receptor antagonists (bosentan or losartan) or vehicle (saline) in the femoral vein 20 min before, during and 20 min after the period of ischaemia. L-NAME was given as i.v. bolus before each antagonist infusion. All parameters were measured 24 h after reperfusion.
Our results showed that strong NO blockade overcame effects of both ET and AII receptor blockade in experimental post-ischaemic ARF. In addition, the AII receptor blockade had a harmful effect on this condition, probably due to disturbed autoregulatory renal function. On the other hand, ET and AII receptor blockade in mild NO blockade associated with reperfusion injury, improves the most haemodynamic, biochemical and morphological parameters.
We concluded that experimental post-ischaemic ARF is neither AII nor ET mediated in case of strong NO blockade, but, in more realistic conditions of mild NO deficiency, these peptides represent significant players whose receptor blockade expressed relevant therapeutic potential.
急性肾衰竭(ARF)是一种严重疾病,尤其当它发生于一氧化氮(NO)合成受损的各种情况下,如动脉高血压、心力衰竭及某些肾脏疾病时。我们已将研究方向指向在实验性缺血后急性肾衰竭中,血管紧张素II(AII)和内皮素(ET)受体阻断联合轻度或重度NO缺乏对血流动力学、生化及形态学参数的影响。
在本研究中,我们使用了波生坦(双重ETA/ETB受体拮抗剂)、氯沙坦(非肽类I型AII受体竞争性拮抗剂)以及NO合成抑制剂NG-硝基-L-精氨酸甲酯(L-NAME)。实验在麻醉的成年雄性Wistar大鼠身上进行。切除右肾,通过夹闭左肾动脉45分钟造成肾缺血。实验组在缺血期前20分钟、缺血期及缺血期后20分钟经股静脉接受受体拮抗剂(波生坦或氯沙坦)或赋形剂(生理盐水)。在每次输注拮抗剂前静脉推注L-NAME。所有参数在再灌注24小时后测量。
我们的结果显示,在实验性缺血后急性肾衰竭中,重度NO阻断克服了ET和AII受体阻断的作用。此外,AII受体阻断对这种情况有有害影响,可能是由于肾自动调节功能紊乱。另一方面,在与再灌注损伤相关的轻度NO阻断中,ET和AII受体阻断改善了大多数血流动力学、生化及形态学参数。
我们得出结论,在重度NO阻断情况下,实验性缺血后急性肾衰竭既不是由AII介导也不是由ET介导,但在更符合实际的轻度NO缺乏情况下,这些肽是重要参与者,其受体阻断表现出相关治疗潜力。